FREQUENCY OF MATERNAL MORTALITY AND MORBIDITY IN PREGNANCY-INDUCED HYPERTENSION

Authors

  • Shazia Riaz
  • Saadia Habib
  • Alia Jabeen

Abstract

Background: Pregnancy-induced hypertension (PIH) is defines as hypertension in pregnancy, and issustained blood pressure >140 mm Hg systolic or 90 mm Hg diastolic. Objective of this study was tosee the maternal outcome in terms of morbidity and mortality in PIH. Methods: This descriptivestudy was conducted in Obstetrics and Gynaecology Unit of Fauji Foundation Hospital, Rawalpindifrom January to December 2010. Both booked and un-booked cases were selected after fulfillinginclusion criteria. A detailed history and clinical examination was recorded and relevantinvestigations were performed. Patients were monitored for rise in blood pressure, development ofcomplications related to hypertensions in pregnancy as well as maternal and perinatal outcome.Results: During this period, 100 patients were admitted with pregnancy-induced hypertension.Majority were un-booked. Primigravida were 60 (60%), and were in age group 21–30 year,remaining were above 30 year. Four patients had placental abruption, 2 pulmonary oedema, 5HELLP syndrome, 2 severe renal impairment, 20 elevated liver enzyme, 23 uncontrolled bloodpressure, 20 server preeclampsia, 10 thrombocytopenia, 3 eclampsia, 10 had impaired coagulationprofile, and 1 had maternal death. Conclusion: Pregnancy induced hypertension is a major cause ofmaternal mortality and morbidity. In Pakistan, its incidence and related mortality are high due to lackof adequate antenatal care.Keywords: Maternal Mortality, Maternal Morbidity, Pregnancy

References

Mugo M, Govindarajan G, Kuru Kalasuriya LR, Sowers

JR, McFarlane SI. Hypertension in pregnancy. Curr Hypertens

Rep 2005;7:348–54.

The Seventh Report of the Joint National Committee on

Prevention, Detection, Evaluation, and Treatment of High

Blood Pressure. National High Blood Pressure Education

Program (USA) 2000. p.50.

Easterling TR, Carr DB, Brateng D, Diederichs C, Schmucker

B. Treatment of Hypertension in Pregnancy: Effect of atenolol

on maternal disease, preterm delivery and fetal growth. Obstet

Gynecol 2001;98:427–33.

Dekker G. Hypertension. High Risk Pregnancy, 4th ed. London:

Elsevier; 2010.p. 599–626.

Sibai BM, Barton JR. Expectant management of severe

preeclampsia remote from term: patient selection, treatment,

and delivery indications. Am J Obstet Gynecol

;196(6):514.e1–9.

Hallak M. Hypertension in Pregnancy. In: high risk pregnancymanagement options, 2nd ed. London: WB Sauders; 1999.

J Ayub Med Coll Abbottabad 2011;23(4)

http://www.ayubmed.edu.pk/JAMC/23-4/Shazia.pdf 63

Naz T, Nisa M, Hassan L. Eclampsia –management and

outcome with magnesium sulphate as the convulsant. J Coll

Physicians Surg Pak 2005;15:624–7.

Naseer-ud-Din, Khan A, Illahi N. Perinatal and maternal

outcome of eclamptic patients admitted in Nishtar Hosp

Multan. J Coll Physician Surg Pak 2000;10:261–4.

Malik A, Ahmed K, Sadiq I, Yousaf W. Changing pattern of

eclampsia over a 20 years period. Ann King Edward Med Coll

;6:194–5.

Bharathi KN, Prasad KV SRG, Yagannatha Pairu, Naik BC,

Comparison of anti hypertensive efficacy of labetotol,

Nifedipine and methyldopa in pregnancy induced hypertension.

Pharmacologyonline 2009;3:670–8.

Won HS, Kim DY, Yang MS, Lee SJ, Hyun-Ho Shin, Park JB.

Pregnancy induced hypertension, but not gestational diabetes

Mellitus, is a risk factor for venous thrombo-embolism in

pregnancy. Korean Circ J 2011;41:23–7.

Levy JA, Murphy LD. Thrombocytopenia in pregnancy. J Am

Board Fam Pract 2002;15(4):290–7.

Sibai BM. Hypertension. In: Gabbe SG, Niebly JR, Simpson

JL, editors. Obstetrics normal and problem pregnancies. 5th ed.

Philadelphia: Elsevier Churchill Livings Stone; 2007: Chap 33.

Peng Z. Acute renal failure in severe pregnancy induced

hypertension: a report of 19 cases. Zhonghua Fu Chan Ke Za

Zhi 1993;28(5):281–3.

Rahim R, Shafqat T, Ruby NF. An analysis of direct causes of

material mortality. J Postgrad Med Ins 2006;20:86–91.

World Health Organization, Reduction of material mortality. A

joint WHO/UFPA/UNICFE/World bank Statement. Geneva

Available at: http://www.searo.who.int/LinkFiles/

Publications_Reduction_of_Maternal_Mortality.pdf

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Published

2011-12-01